Title

The ongoing effect of diabetes during pregnancy and the impact on infants

Document Type

Other

Publication Title

The Lancet Regional Health - Western Pacific

Publisher

Elsevier

RAS ID

32158

Comments

Strobel, N. A., & McAullay, D. (2020). The ongoing effect of diabetes during pregnancy and the impact on infants [Review of the research paper Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years, by M. J. L. Hare, F. Barzi, J. A. Boyle, S. Guthridge, R. F. Dyck, E. L. M. Barr, ... L. J. Maple-Brown]. The Lancet Regional Health - Western Pacific, 1, article 100009. https://doi.org/10.1016/j.lanwpc.2020.100009

Abstract

Background: Early-life risk factors, including maternal hyperglycaemia and birthweight, are thought to contribute to the high burden of cardiometabolic disease experienced by Indigenous populations. We examined rates of pre-existing diabetes in pregnancy, gestational diabetes mellitus (GDM) and extremes of birthweight over three decades in the Northern Territory (NT) of Australia. Methods: We performed a retrospective cohort analysis of the NT Perinatal Data Collection from 1987 to 2016, including all births > 20 weeks gestation, stratified by maternal Aboriginal identification. Key out- comes were annual rates of pre-existing diabetes, GDM, small-for-gestational-age, large-for-gestational- age, low birthweight ( < 2500 g), and high birthweight ( > 40 0 0 g). Logistic regression was used to assess trends and interactions. Findings: 109 349 babies were born to 64 877 mothers, 36% of whom identified as Aboriginal ethnicity. Among Aboriginal women, rates of GDM and pre-existing diabetes, respectively, were 3 ·4% and 0 ·6% in 1987 and rose to 13% and 5 ·7% in 2016 (both trends p < 0 ·001). Among non-Aboriginal women, rates of GDM increased from 1 ·9% in 1987 to 11% in 2016 ( p < 0 ·001), while pre-existing diabetes was uncommon ( ≤ 0 ·7% throughout). Rates of small-for-gestational-age decreased, while rates of large-for-gestational- age and high birthweight increased in both groups (all trends p < 0 ·001). Multivariable modelling sug- gests that hyperglycaemia was largely responsible for the growing rate of large-for-gestational-age births among Aboriginal women.

DOI

10.1016/j.lanwpc.2020.100009

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